On 5 December 2019 Prague joined the Fast Track Cities initiative. The Czech capital thus aligned itself with the world metropolises that have opted to pro-actively counter the HIV epidemic. 

The long-term effort to make Prague part of the Fast Track Cities initiative has been successful. The new city hall leadership has voted to embrace the initiative that could ensure a more active fight against spreading HIV and AIDS in the Czech Republic. The declaration was signed today at the Mayor’s residence by Zdenek Hrib, the mayor of Prague, Milena Johnova, the city councilor in charge with social and health issues, and Bertrand Audoin of the organization Association of Providers of AIDS Care (IAPAC), which was at the origin of Fast Track Cities. 

What is this all about? In 2014, the local authorities in many big cities lost their patience. They stopped waiting for the national ministries to wake up, and decided to take themselves measures to improve the situation regarding the HIV epidemic. This is how the Fast Track Cities was born – embraced initially by Paris. The global net includes over 300 cities on all continents except for Antarctica. 

The associated metropolises have a common goal: 90-90-90. 90% of HIV-positive people to be made aware of their status, 90% of them to have access to retroviral medication and 90% of them to reach the zero-load level (that is when someone has the virus in their body at minimal level, making contagion impossible). Furthermore, 2030 is the deadline for getting rid of any new infections. 

According to the Czech AIDS Relief Society data, the main way to get HIV-infected in the Czech Republic is through sexual contact between men (66,3% of all new infections compared to 23% through heterosexual sex). The current uptrend in infections has been encouraged by sexual tourism. Prague is second in Europe after Lisbon as a destination for sexual tourist. (Source: zezdravotnictvi.cz/zpravy/praha-se-pripoji-k-iniciative-k-ukonceni-epidemie-aids/)

Concrete changes in Prague

What will Prague do to reach those ambitious goals? The plan is to establish a team of experts dealing with prevention, diagnosis, treatment and research – not only of HIV, but also other STD, such as hepatitis B, C and tuberculosis. 

“Fast Track Cities membership doesn’t mean anything - by itself. What it does give us is an opportunity to share and exchange information. The steps taken by the city hall are positive, signaling that Prague is taking seriously its decision to fight actively and effectively against HIV”, says Petr Kalla, a member of the Prague Pride association leadership. 

Thanks to the connections with other Fast Track Cities metropolises, our experts will be able to use those cities’ experiences. Those concern not only the prevention and treatment, but also awareness work through various channels, first and foremost via the social media. Raising awareness and educating the public is very important – many Czechs for instance have no idea that thanks to the currently available medical treatment, HIV positive people don’t have to be contagious at all. This and many other things should change, and the society should become more understanding with the disease, and more inclusive with its bearers. 

“The experiences of foreign countries and cities show that by lowering the level of stigmatizing and discrimination against HIV-positive people, one can fight the HIV more effectively. This also removes the mental barrier that makes so many people avoid timely HIV-testing, and opens the way to an early beginning of medical treatment, which in turn not only prolongs the lives of the HIV-positive, but also prevents transmitting the virus to other people”, Petr Kalla adds.

The effectiveness of such measures has been tested in practice in many parts of the world. London, for instance, has reported a 40% drop in infections after it joined the initiative. The main effect of this initiative is that the members of risk groups in the population get tested much more often. This enhances access to treatment and to the PrEP medication – the pills that prevent healthy people from getting infected when exposed to the virus.  

Text: Hynek Toman

Translation: Mircea Ticudean

Photo: Martin Kovář